Monitored anesthesia care and asleep-awake-asleep techniques combined with multiple monitoring for resection of gliomas in eloquent brain areas:a retrospective analysis of 225 patients

作     者：San-Zhong Li Ning Su Shuang Wu Xiao-Wei Fei Xin He Jiu-Xiang Zhang Xiao-Hui Wang Hao-Peng Zhang Xiao-Guang Bai Guang Cheng Zhou Fei 

作者机构：Department of NeurosurgeryXijing HospitalFourth Military Medical UniversityXi’an 710032China Department of RadiotherapyXijing HospitalFourth Military Medical UniversityXi’an 710032China Department of AnesthesiologyXijing HospitalFourth Military Medical UniversityXi’an 710032China 

出 版 物：《Chinese Neurosurgical Journal》 (中华神经外科杂志（英文）)

年 卷 期：2023年第9卷第2期

页      面：88-97页

核心收录：

学科分类：1011[医学-护理学（可授医学、理学学位）] 10[医学] 

基　　金：funded by multidisciplinary MDT diagnosis and treatment fund for glioma and academic discipline boosting of Xijing Hospital 

主　　题：Monitored anesthesia care(MAC) Asleep-awake-asleep(AAA) Retrospective analysis Eloquent areas Gliomas 

摘      要：Background:Awake craniotomy(AC)has become gold standard in surgical resection of gliomas located in eloquent *** conscious sedation techniques in AC include both monitored anesthesia care(MAC)and asleep-awake-asleep(AAA).The choice of optimal anesthetic method depends on the preferences of the surgical team(mainly anesthesiologist and neurosurgeon).The aim of this study was to compare the difference in physiological and blood gas data,dosage of different drugs,the probability of switching to endotracheal intubation,and extent of tumor resection and dysfunction after operation between AAA and MAC anesthetic management for resection of gliomas in eloquent brain ***:Two-hundred and twenty-five patients with super-tentorial tumor located in eloquent areas underwent AC from 2009 to 2021 in Xijing ***-one patients underwent AAA technique,and the rest one-hundred eighty-four patients underwent MAC *** management,dosage of different drugs,intraoperative complications,postoperative outcomes,adverse events,extent of resection and motor,and sensory and language dysfunction after operation were compared between MAC and ***:There was no significant difference in gender,KPS score,MMSE score,glioma grade,type,and growth site between the patients in the two groups,except the older age of patients in MAC group than that in AAA *** the whole process of operation,there were greater pulse pressure difference(P=0.046),shorter operation time(P=0.039),less dosage of remifentanil(P=0.000),more dosage of dexmedetomidine(P=0.013),more use of antiemetics(81%,P=0.0067),lower use of vasoactive agent(45.1%,P=0.010),and lower probability of conversion to general anesthesia(GA,P=0.027)in MAC group than that in AAA *** gas analysis showed that PetCO2(P=0.000),Glu concentration(P=0.000),and PaCO2(P=0.000)were higher,but SPO2(P=0.002)and PaO2(P=0.000)were lower in MAC group than that in AAA *** the postoperative recovery stage,c